Health in Southeast Asia 3 Emerging infectious diseases in southeast Asia: regional challenges to control

Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
The Lancet (Impact Factor: 45.22). 02/2011; 377(9765):599-609. DOI: 10.1016/S0140-6736(10)62004-1
Source: PubMed

ABSTRACT Southeast Asia is a hotspot for emerging infectious diseases, including those with pandemic potential. Emerging infectious diseases have exacted heavy public health and economic tolls. Severe acute respiratory syndrome rapidly decimated the region's tourist industry. Influenza A H5N1 has had a profound effect on the poultry industry. The reasons why southeast Asia is at risk from emerging infectious diseases are complex. The region is home to dynamic systems in which biological, social, ecological, and technological processes interconnect in ways that enable microbes to exploit new ecological niches. These processes include population growth and movement, urbanisation, changes in food production, agriculture and land use, water and sanitation, and the effect of health systems through generation of drug resistance. Southeast Asia is home to about 600 million people residing in countries as diverse as Singapore, a city state with a gross domestic product (GDP) of US$37,500 per head, and Laos, until recently an overwhelmingly rural economy, with a GDP of US$890 per head. The regional challenges in control of emerging infectious diseases are formidable and range from influencing the factors that drive disease emergence, to making surveillance systems fit for purpose, and ensuring that regional governance mechanisms work effectively to improve control interventions.

Download full-text


Available from: Piya Hanvoravongchai, Jul 28, 2015
1 Follower
  • Source
    • "The number of malaria cases and malaria-induced mortality in Myanmar has been consistently high for the past three decades (Cui et al., 2012b). Factors such as the emergence/spread of Plasmodium falciparum resistance to artemisinins and P. vivax resistance to chloroquine , inadequate epidemiological data to assess malaria situations, complex vectorial systems, and above all civil unrest make malaria control very difficult in Myanmar (Coker et al., 2011; Cui et al., 2012a,b; Delacollette et al., 2009; Cheeseman et al., 2012; Phyo et al., 2012; Li et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: In Myanmar, civil unrest and establishment of internally displaced persons (IDP) settlement along the Myanmar-China border have impacted malaria transmission. The growing IDP populations raise deep concerns about health impact on local communities. Microsatellite markers were used to examine the source and spreading patterns of Plasmodium falciparum between IDP settlement and surrounding villages in Myanmar along the China border. Genotypic structure of P. falciparum was compared over the past three years from the same area and the demographic history was inferred to determine the source of recent infections. In addition, we examined if border migration is a factor of P. falciparum infections in China by determining gene flow patterns across borders. Compared to local community, the IDP samples showed a reduced and consistently lower genetic diversity over the past three years. A strong signature of genetic bottleneck was detected in the IDP samples. P. falciparum infections from the border regions in China were genetically similar to Myanmar and parasite gene flow was not constrained by geographical distance. Reduced genetic diversity of P. falciparum suggested intense malaria control within the IDP settlement. Human movement was a key factor to the spread of malaria both locally in Myanmar and across the international border. Copyright © 2015. Published by Elsevier B.V.
    Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases 05/2015; 33. DOI:10.1016/j.meegid.2015.05.002 · 3.26 Impact Factor
  • Source
    • "The main objective of this workshop was to join ecologists, biologists, and epidemiologists to give an overview on the importance of rodents as hosts and reservoirs of parasitic and infectious diseases. Most of presentations given in the workshop focused in Southeast Asia, a hotspot of both infectious emerging diseases (Coker et al. 2011) and biodiversity at threat due to dramatic changes in land use (Morand et al. 2014). A first challenge is related to the invasion or range expansion of rodents. "
    Vector borne and zoonotic diseases (Larchmont, N.Y.) 01/2015; 15(1):1-2. DOI:10.1089/vbz.2015.15.1.intro · 2.53 Impact Factor
  • Source
    • "Furthermore, this private–public partnership relies on the efforts of 'upstream' officials and the quality of their engagement with the private village-level workers (FAO, 2013). Surveillance is the foundation of infectious disease control, and poor reporting sensitivity and specificity is problematic (Coker et al., 2011), particularly when attempting to estimate financial burdens and undertake economic modelling for supporting control decisions. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Foot and mouth disease (FMD) is endemic in Cambodia and throughout the Greater Mekong Subregion and causes significant losses to rural smallholders owning the majority of the national large ruminant population. However, due to underreporting, paucity of knowledge of FMD impacts, limited veterinary capacity and deficits of data available for analysis, the quantifiable benefits of a national FMD control programme are unknown. To address this deficit, existing literature and research data from the ‘Best practice health and husbandry of cattle, Cambodia' project conducted between 2007 and 2012, were used to develop a three-phase analysis framework to: assess the impacts of the recent widespread FMD epizootic in Cambodia in 2010, conduct a value chain analysis of the large ruminant market and estimate the costs and benefits for a national large ruminant biannual FMD vaccination programme. A trader survey conducted in 2010–2011 provided cattle and buffalo value chain information and was matched to village herd structure data to calculate a total large ruminant farm-gate value of USD 1.271 billion in 2010. Monte Carlo simulation modelling that implemented a 5-year biannual vaccination programme at a cost of USD 6.3 an animal per year identified a benefit-cost ratio of 1.40 (95% CI 0.96–2.20) when accounting for recent prices of cattle and buffalo in Cambodia and based on an expected annual incidence of 0.2 (assuming one major epizootic in the 5-year vaccination programme). Given that the majority of the large ruminants are owned by rural smallholders, and mostly the poor are involved in agricultural employment, the successful implementation of an FMD control programme in Cambodia would be expected to avoid estimated losses of USD 135 million; equivalent to 10.6% of the 2010 farm-gate value and contributing to important reductions in rural poverty and food insecurity.
    Transboundary and Emerging Diseases 11/2014; DOI:10.1111/tbed.12292 · 3.12 Impact Factor
Show more